PHBLM PROJECT. Increasing Public Health Safety Alongside the New Eastern European Border Line

Transcription

1 PHBLM PROJECT Increasing Public Health Safety Alongside the New Eastern European Border Line Co-funded under the European Commission s Public Health Programme 2006 Piloting of Training Materials of March 2010, Pécs MEETING MINUTES In line with the Project Description and in agreement with the Executive Agency for Health and Consumers (EAHC), IOM invited governmental stakeholders and project partners to the Piloting of Training Materials in Pécs on of March 2010, hosted by the University of Pécs. The objectives of the meeting were to: present and discuss the training materials, developed within the PHBLM project with governmental stakeholders and project partners; collect feedback on the content of the training materials for their revision and finalization by EASP; The participants in the meeting included representatives from IOM, University of Pécs, the Andalusian School of Public Health (EASP), government experts from the Border Guard HQs and Training Schools, Ministries of Health and public health authorities of the project s target countries (Hungary, Poland, Slovakia and Romania) and the University of Trnava. Documents provided in Annex: Agenda List of Participants Project Summary List of training modules for BGs and HPs Points of Discussion: 1. Opening addresses. Introduction to the meeting and participants The meeting began with opening addresses from Prof. Dr. Péter Németh, Dean of the Medical faculty at the University of Pécs, followed by Jeffrey Labowitz, IOM Regional Representative and Prof. Dr. Gábor Ternák, UP coordinator for the PHBLM project. After an introduction of the participants in the meeting and their areas of personal and institutional expertise, video presentation of the history of the Medical School, overview of the University of Pécs Medical School migration health programs (Prof. Dr. István Szilárd) and the evaluation methodology of the Medical School migration health programs (Prof. Árpád Baráth) were presented to the public. Ms. Roumyana Petrova-Benedict, PHBLM Project Manager and Senior Regional Migration Health Manager for Europe and Liaison to the EU from the International Organization for Migration, This meeting arises from the project Increasing Public Health Safety Alongside the New Eastern European Border Line (PHBLM) which has received funding from the European Union, in the framework of the Public Health Programme, and the Government of Hungary. The PHBLM Project is managed by the International Organization for Migration (IOM Brussels), with the associated partnership of the University of Pécs.

2 welcomed the participants in the Piloting of Training Materials and provided an overview of the migration health work of IOM in Europe and PHBLM project implementation so far. Ms. Bibiana Navarro from the Andalusian School of Public Health (EASP) closed the opening session with a brief overview of the training modules for BGs and HPs and the methodology to be applied during the following three days a participatory approach, within which the participants in the meeting would present the training materials. She explained that the training materials for BGs and HPs consist of three modules: Module I Migration and the right to health care, Module 2 Well-being: Public/Individual health and Module 3 Intercultural competence, sub-divided into several units for both BGs and HPs. 2. Presentation and discussion of training materials for border officials and for health professionals. Day 1. The discussion of the training materials, developed within the PHBLM project, started with a presentation of the first three units of Module I Migration and the right to health care, similar for BGs and HPs: Unit 1 Push-pull factors and other terminology, dealing with the impact of migration in the EU, Unit 2 Global and European migration trends and Unit 3 Equal and current access to health care at EU and local level, presented by Ms. Eva Gallova from Trnava University. The first three units were assessed from the participants as interesting, providing correct definitions, participatory with impressive video presentations and providing a clear image of the migration process. The participants in the session recommended adding to the materials more concrete examples (especially in relation to the legal discussion of the right to health), practical applications and statistics making the presentations more dynamic and touching, as well as elaborating more on the migration and health aspect of the first module. The technical aspects of the training materials were also discussed - good quality videos with subtitles are needed for demonstrating the messages of the module. After the first session on Module 1 (units 1 to 3) for both BGs and HPs, Marzena Korolko from the Polish BGs presented Module III, unit 9 Intercultural competency: concepts, principles and unit 10 Communication skills, both for BGs and HPs. Again the presentation was followed by an open discussion, during which the participants provided positive feedback on the module presented. Major recommendations consisted in providing more information on the non-verbal communication,: nonverbal differences between cultures, examples of non-verbal misunderstandings (different understanding of words, idioms, facial expressions (tips and skills building). As well as less theoretical elements and examples on the cultural differences and more practical exercises on how to build trust and prevent conflicts through active listening. Participants agreed on the importance of the general awareness of cultural diversity. Slides on health taboos, nutrition habits, videos that depict situations of communication gaps, communication skills gestures quizzes and intercultural competence awareness activities would enrich the training materials. It was also suggested that after the general introduction a guest from different cultural background is invited so that the trainer demonstrates a cultural sensitive interview. The final unit, presented at the first day of the meeting was unit 12 Intercultural mediation, an additional unit within module III Intercultural competence developed only for HPs and demonstrated by Eva Gallova from Trnava University. Assessed as a good training material, the following improvements were suggested: videos, maps, adding a section on working/cooperation with the community, from where mediators can be recruited, especially in respect of preventive actions in case of conflicts, exercising on tips/what to do in preventing conflicts. Ms. Roumyana Petrova-Benedict suggested that the intercultural mediation unit should be offered also for BGs and divided into three sub-sections: working with interpreters; working without interpreters and working with a cultural mediator. 2

3 Day 2. The second day of the meeting continued with review of Module II Well Being-Public and Individual Health for BGs, Unit 5 First aid. What are and how to recognize the alarm signs in people who require immediate attention from a health professional, unit 6 Basic concepts on epidemic-pandemic alert and response. Practical concepts on the different modes of transmission and protection against the most prevalent communicable diseases, unit 7 Occupational mental health & stress and conflict management and unit 8 Vulnerability factors and groups. Ms. Zora Bruchacova, Medical CEO at the MoI, Slovakia opened the morning session with a overview of unit 5 and 6 for BGs. Participant s feedback on unit 5 was that the materials are excellent pedagogical tools with clear messages. Again, more examples, practical exercises with mannequins and more visual materials were recommended. It was discussed that first aid refreshment exercises should be made on a regular basis at least every two years. Prof. Dr. Gábor Ternák pointed out that the group of BGs (non medical persons without medical knowledge) is not well targeted and that the goal of this unit to provide basic knowledge on primary care, as of relevance for BGs (what they can do), should be clearly stated. Overall, participants agreed that more time is needed for this unit one hour for theoretical training and 4-5 hours for the practical exercises. Unit 6 Basic concepts on epidemic-pandemic alert and response. Practical concepts on the different modes of transmission and protection against the most prevalent communicable diseases was evaluated as clear and logical. Again, more pictures, cases and specific activities for BGs were recommended to the authors of the materials. Prof. Dr. Gábor Ternák insisted on the fact that migration health has nothing to do with GAR (WHO Integrated global alert and response system for epidemics and other public health emergencies) and that what is important for BGs is to teach them what to look for and how to recognize symptoms such as wounds, skin rashes, etc. Other participants in the meeting noted that it is important from an educational point of view to have a few slides on the work of WHO and ECDC, including also a brief introduction to GAR. Prof. Dr. Gábor Ternák explained that BGs should know that if a migrant is coming from Africa/Asia, they should think of malaria, typhoid fever, etc. and thus recognize their symptoms (fever and/or vomiting) without going into many details. Participants in the meeting further discussed which diseases should be reviewed in the training materials, both communicable and non-communicable so that the information provided is optimal for the needs of BGs. Unit 7 Occupational mental health & stress and conflict management and Unit 8 Vulnerability factors and groups both for BGs were presented by Ewa Kownacka, intercultural psychologist and trainer, working with IOM Warsaw. Starting with unit 7, the audience reacted positively to the presentations and assessed them as interesting, clear and practical. Again, being more targeted to the specific needs of BGs was recommended during the discussion. Making link with detention conditions and what can be done in detention context where the general societal interventions are even more difficult to apply were other suggestions during the discussions. It was noted that the description of risk factors and most vulnerable groups e.g. trafficked persons, people with PTSD, torture victims etc. needs to be present in the presentations and discussions, as well as slides on guiding principles of working with vulnerable groups. Ms. Roumyana Petrova Benedict suggested adding to the unit a section, describing symptoms and the need to understand and deal with migrants ensuing frustration, vandalism, hunger strikes, self harm. More pictures, diagrams, crisis intervention techniques, exercises similar to the stress release activity of breathing techniques, presented within this unit, were other suggestions during the discussion. Unit 8 Vulnerability factors and groups was assessed as useful and very professionally developed. Participants again commented to add more practical tips regarding the overall health promotion education, the vaccinations to take, on the nutrition diet and healthy lifestyles (alcohol, tobacco ). Examples for specific stressors for BGs to be included and exercises focused on BGs experience, suggestions for group work and sharing of stress relief after encounter with stressful/ traumatic 3

4 event and how to deal with their own feelings and frustration, when witnessing vandalism/hunger strikes/self harm behavior were again recommended. The last unit, presented by Ewa Kownacka the second day of the meeting was unit 9 for HPs Psychosocial implications of migration. Migrant s coping strategies. Participants in the meeting insisted on the importance of having clear and concise information, sensitizing the staff of how to communicate with migrants in detention. Understanding the importance of being heard, expressing grief/frustrations and receiving attention were discussed as very important for HPs working with migrants. In this respect, the authors of the unit were advised to decrease the text content of the presentation within this unit, use simple terminology, add more specific details on the situation in detention and the risks and symptoms that BGs face and how to react/prevent themselves. Connection between this unit and Unit 7 Occupational mental health & stress and conflict management were discussed. Day 3. The third day of the meeting continued with an overview of Module II Well being: Public and Individual Health for HPs : unit 5 Communicable diseases, unit 6 Occupational health: concepts on safety, hygiene, infection control and well-being at the work place, unit 7 Epidemic & pandemic alert and response, unit 8 Skills for dealing with victims of trafficking and the remaining unit 4 from Module I Antidiscrimination and ethics. Prof. Dr. Gabor Ternák from the University of Pécs started the morning session by presenting the training materials and sharing his experience from his work in Africa and Asia. He pointed out that diseases coming through the border are not only communicable but also non-communicable and that a presentation with practical examples and lessons learnt from direct work with migrant patients and pictures are needed for HPs. He explained that it is important for social workers and health professionals to know not only the symptoms of the diseases but also how to take care of their safety. The pictures showed during the presentations raised comments that they can even be useful for BGs to have an idea of the main and unique symptoms of number of communicable diseases. There were comments in the room that such a unit is very useful for the HPs preparation in highlightening what is important in preventing diseases outbreaks. Everybody agreed that pictures with some of the key conditions and action needs to be taken should be incorporated in the presentation materials. As regarding the GAR and the usefulness of adding it to the training modules, there was no actual consensus in the group. Unit 6 Occupational health: concepts on safety, hygiene, infection control and well-being at the work place for HPs was briefly presented from Dr. Gyula T. Szipola from Hungary. Similar to the unit on BGs occupational health, the recommendations were to add pictures and actions/ warning or no action / no worry. In this section, a reference to the ECDC migrant and communicable disease report series and figures as to epidemiological situation in Europe were also advised. As unit 7 Epidemic & pandemic alert and response for HP covered similar topics to unit 6 for BGs, it was not discussed again. The discussion moved directly to the presentation on unit 8 Skills for dealing with victims of trafficking, presented by Daniel Verman from the MoH, Romania and VoTs focal point. The presentation was evaluated as useful, clear and with numerous details on the diagnostic and psychological aspects of the problem (e.g. eating disorders, constipation, sexual abuse, etc). The patient-centered approach to examination and diagnosis was highlighted with the only recommendation that extra and external support for VpTs is needed and that HPs should know where to and to whom to refer. BGs also requested that they also have the information/guidelines on VoTs added to their modules as useful for their work too. Prof. Dr. István Szilárd added that organ transplantation should be part of the list of reasons for trafficking of people and that the Budapest declaration should be mentioned in the background information of this unit. A request to add referral mechanisms (rules) and steps to follow for VoTs in the methodological guidelines was suggested by Daniel Verman, who also noted that he will provide more slides and information on the labor migration issues related to VoTs. 4

5 The last unit discussed during the third day was unit 4 from Module I Ethics and Antidiscrimination, presented by Roxana Munteanu from the BGs Training School in Romania. Assessed as important and interesting, the participants in the meeting suggested that this unit should be extended and cover also some ethical and antidiscrimination references made in other units. More examples from real life, practical activities and case studies were again suggested to be added in order to stimulate the trainees to think on the topic. 3. Conclusions and next steps Ms. Benedict closed the meeting by thanking EASP and all participants for their hard work and valued contributions to the review of training materials within the PHBLM project. Participants were reminded of the next steps of the project, for which IOM offices will be in contact with them in the coming months: Anonymous administrative evaluation of the Piloting of Training Materials meeting o IOM will send questionnaires to participants Summary of the recommendations and finalization of the training materials by EASP before the Final EU Dissemination event in Brussels on the of May 2010 o IOM will disseminate the training materials to all participants in the Piloting of Training Materials Meeting Final EU Dissemination event, Brussels, of May 2010 For further information, participants are invited to contact their local IOM Country Coordinator or the Migration Health Unit in IOM Brussels. 5